Chapter 10: Cultural Diversity and Values

Copyright © 2016 Wolters Kluwer • All Rights Reserved Chapter Highlights Culture in community settings Cross-cultural nursing Cultural competence and related concepts How culture affects health Cultural health assessment Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Question Is the following statement true or false? Culture is static, private, and inherited. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Answer False Rationale: Culture is dynamic, shared, and learned. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Culture and Nursing Culture—knowledge, values, practices, customs, and beliefs of a group Properties of culture Dynamic, not static Shared, not private Learned, not inherited Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Question Is the following statement true or false? Cultural competence is an attitude of openness to, respect for, and curiosity about different cultural values and traditions, and ideally includes a broader critical analysis of power relations affecting health disparities. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Answer True Rationale: Cultural competence is an attitude of openness to, respect for, and curiosity about different cultural values and traditions, and ideally includes a broader critical analysis of power relations affecting health disparities. For community health nurses, it necessitates familiarizing oneself with cultures that are represented in the communities they serve. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Cross-cultural Nursing Cross-cultural or transcultural nursing—any nursing encounter in which the client and nurse are from different cultures Cultural competence—considering cultural aspects of health, illness, and treatment for each client or community, as well as doing so at each stage of the nursing process Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Question Is the following statement true or false? Advocates for groups that have been sociopolitically marginalized promote “cultural safety,” the ideal of considering cultural aspects of groups while working against assimilationism and repression. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Answer True Rationale: Advocates for groups that have been sociopolitically marginalized promote “cultural safety,” the ideal of considering cultural aspects of groups while working against assimilationism and repression. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Institutional Cultural Competence For community and public health agencies to be culturally competent, they must Have a defined set of values and principles and demonstrate behaviors, attitudes, policies, and structures that enable them to work effectively cross-culturally Copyright © 2016 Wolters Kluwer • All Rights Reserved

Institutional Cultural Competence (cont.) Have the capacity to Value diversity Conduct self-assessment Manage the dynamics of difference Acquire and institutionalize cultural knowledge Adapt to diversity and the cultural contexts of the communities they serve Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Question Is the following statement true or false? Cultural humility is an acknowledgment that our own beliefs are inherently better than those of our clients. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Answer False Rationale: Cultural humility is an acknowledgment that everyone’s views are culturally influenced, that our own are not inherently better than those of our clients, and that our clients can teach us. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Cultural Safety Culturally appropriate health services to disadvantaged groups while stressing dignity and avoiding institutional racism, assimilationism, and repressive practices Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Cultural Humility Ask open-ended questions about beliefs and practices of the client and family. Ask about traditions. What does the client think may have caused an illness, and how has the client already tried to address it? Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Question Is the following statement true or false? Ethnocentrism can be defined as an assumption that everyone shares your cultural values, or an opinion that your culture is superior to others. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Answer True Rationale: Ethnocentrism can be defined as an assumption that everyone shares your cultural values, or an opinion that your culture is superior to others. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Ethnocentrism Assumption that others believe and behave as the dominant culture does, or the belief that the dominant culture is superior to others Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Subculture Group sharing some practices, language, or other characteristics in common, within a larger society that does not share those characteristics Copyright © 2016 Wolters Kluwer • All Rights Reserved

Western Biomedicine as “Cultured” The first imperative of cultural competence is to be competent in one’s own cultural heritage. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Aspects of Culture Directly Affecting Health and Health Care Attribution of illness Diet Verbal communication Nonverbal communication Eye contact Personal space Style of communication Copyright © 2016 Wolters Kluwer • All Rights Reserved

Aspects of Culture Directly Affecting Health and Health Care (cont.) Time orientation Roles Religion Folk medicine Copyright © 2016 Wolters Kluwer • All Rights Reserved

Cultural Health Assessment Individual clinicians Healthcare organizations Copyright © 2016 Wolters Kluwer • All Rights Reserved